CMS Formulary

Displaying 116111-116120 of 1611142 results.
ID: 116111
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 116112
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 116113
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116114
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116115
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 116116
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116117
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 116118
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 116119
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 116120
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30